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SPSS PredictiveClaims TM         Solution Summary     SPSS PredictiveClaims is an application which uses prediction and business rules to quickly approve legitimate insurance claims while finding likely cases of fraud. The offering is for property and casualty insurance companies that need to reduce claim cycle times and minimize handling costs, leading to better customer service and increased profitability.       Solution Profile     Improve Insurance Claim Handling and Fraud Detection For property and casualty insurance companies, the key to customer satisfaction is settling claims quickly. In fact, a survey by Accenture revealed that most property and casualty insurance claimants prioritize the speed of claim resolution over the settlement amount offered (Accenture, 2002). Reduce claim cycle times and minimize claim handling costs PredictiveClaims enables you to increase customer service by reducing claim cycle times. And by reducing claim settlement times, you also minimize claim handling costs and loss adjustment expenses (LAE). At the same time, PredictiveClaims helps you conduct more effective claims fraud detection, and make more efficient use of field agents and your special investigation unit. With PredictiveClaims, property and casualty insurers can:  Quickly approve legitimate insurance claims to improve customer service and minimize loss adjustment expenses and claim handling costs  Identify fraudulent insurance claims at an early stage with a high degree of accuracy—even with large claim volumes  Understand why certain claims are flagged as suspicious, so your special investigation unit know where to focus its investigations  Combine and analyze data from multiple internal and external sources, including federal and insurance industry databases  Integrate with existing claims management systems without extensive customization or lengthy implementation periods Detect claims fraud at an early stage With PredictiveClaims, you determine whether claims are legitimate or fraudulent at an early stage—often in the initial customer conversation. PredictiveClaims integrates with your existing claims management system to deliver risk-based scores in real time, along with reasons for the score. Even with very high claim volumes, PredictiveClaims’ advanced analytics accurately determine whichclaims to settle quickly—and which require follow-up or investigation. Improve the productivity and accuracy of claims handling With PredictiveClaims, property and casualty insurance companies can improve the productivity and accuracy of the entire claim handling process—from first notification of loss to claim settlement—regardless of whether claims are submitted via telephone, fax, mail, the Internet, or in person. Eight of the top 10 global property and casualty insurers on the 2004 FORTUNE Global 500 list are SPSS customers For example, a major insurer handles hundreds of thousands of claims annually through its call center. Using PredictiveClaims to combine risk profiles with business rules—such as claim value guidelines—the company is able to resolve the majority of legitimate claims in just one phone call, while increasing the percentage of fraudulent claims detected at an early stage. As a result, the company has reduced claim handling costs by 30 percent—an annual savings of several million dollars. At the same time, the company has improved customer service and satisfaction by resolving legitimate claims in less time.       Distinguishing Features      Quickly approve legitimate insurance claims to improve customer service and minimize loss adjustment expenses and claim handling costs Identify fraudulent insurance claims at an early stage with a high degree of accuracy—even with large claim volumes Understand why certain claims are flagged as suspicious, so your special investigation unit know where to focus its investigations Combine and analyze data from multiple internal and external sources, including federal and insurance industry databases Integrate with existing claims management systems without extensive customization or lengthy implementation periods         Solution Details      Solution Type: Packaged      Solution Availability:      Company Size Solution is Targeting?: < 50      Open Source Solution: No         Collateral      White Papers: SPSS PredictiveClaims White Papers      Other Collateral: SPSS PredictiveClaims Brochures

http://www.spss.com         Phone (primary): 312 651 3953     233 S. Wacker Dr 11th Floor     Chicago     Illinois     Zip/Postal Code: 60606             Partner Profile           Contact Partner

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